Treating Tumors That Move with Respiration

Harold C. Urschel, Jr. (Editor-in-Chief) John J. Kresl · James D. Luketich Lech Papiez ·Robert D. Timmerman (Co-Editors) Raymond A. Schulz (Contributing Editor) Treating Tumors that Move with Respiration With Contributions by Numerous Experts Foreword by E. Thomson With 116 Figures in 168 Separate Illustrations, 120 in Color and 31 Tables 123 IV Foreword Editor-in-Chief: James D. Luketich, MD Sampson Family Endowed Professor of Surgery Harold C. Urschel Jr. , MD Chief, The Heart, Lung and Chair of Cardiovascular and Thoracic Surgical Esophageal Surgery Institute Research, Education and Clinical Excellence University of Pittsburgh Medical Center, PUH, C-800 Baylor University Medical Center 200 Lothrop Street 1201 Barnett Tower Pittsburgh, PA 15213 3600 Gaston Avenue USA Dallas, TX 75246 USA Lech Papiez, PhD Associate Professor Department of Radiation Oncology University of Texas Southwestern Medical Center 5801 Forest Park Road Dallas, TX 75390 Co-Editors: USA John J. Kresl, MD, PhD Arizona Oncology Services at Robert D. Timmerman, MD St. Joseph’s Hospital & Medical Center Professor and Vice-Chairman Department of Radiation Oncology Ef? e Marie Cain Distinguished Chair in CyberKnife Center Cancer Therapy Research Barrow Neurological Institute Department of Radiation Oncology Gamma Knife Center University of Texas Southwestern Medical Center 350 West Thomas Road 5801 Forest Park Road Phoenix, Arizona 85013 Dallas, TX 75390 USA USA Library of Congress Control Number: 2007920177 ISBN 978-3-540-69885-2 Springer Berlin Heidelberg New York This work is subject to copyright.

Stereotactic radiosurgery continues to evolve in ways that allow this powerful technology to reach and treat more tumors in more patients. This volume in the Robotic Radiosurgery series is devoted to theory and practice in the emerging field of stereotactic radiosurgery (also called stereotactic body radiation therapy) for extracranial tumors, particularly those that move as patients breathe.

The book is divided into six sections. The first three sections address tumor motion due to respiration and tumor tracking techniques; dosimetry, radiobiology, and imaging; and fiducial placement systems. The fourth and fifth sections then discuss in depth the use of robotic radiosurgery to treat lung and abdominal tumors, respectively, and a final section explains emerging concepts and techniques. Within this framework, detailed information is provided on the technology and methodology for delivery of high doses of radiation to moving targets, radiobiological and radiological principles, and the challenges faced by clinicians performing extracranial stereotactic radiosurgery. Furthermore, there are thorough reviews of the general clinical literature on stereotactic radiation treatment of tumors of the lungs, liver, and pancreas, and the latest clinical data from clinicians conducting clinical studies using the CyberKnife® Robotic Radiosurgery System.

Special attention is given to the frameless robotic radiosurgery device known as the CyberKnife, the only image-guided radiosurgery system that utilizes intelligent robotics to track, detect, and correct for changes in tumor position during treatments. Tumors that move with respiration are treated with the CyberKnife using a revolutionary new tool, called the Synchrony® Respiratory Tracking System, which can track moving tumors in real-time. This and other features of the CyberKnife are detailed in chapters by CyberKnife users. In addition, researchers in the broader fieldof stereotactic body radiation therapy were invited to contribute key chapters that place the technical and clinical benefits of CyberKnife into this growing and evolving field.

Efforts have been made to achieve a homogeneous structure throughout the book, and illustrations are of a very high quality. This volume is intended for practitioners and students in all areas of oncology and medicine who are dedicated to the treatment of patients with lesions in the lungs, pancreas, and liver, lesions that move as patients breathe.